Isolated Recurrence of Diffuse Large B-Cell Lymphoma in Sciatic Nerve

Abstract

Sciatica is a common clinical presentation with a number of etiological factors. Many of them are innocuous like prolapsed intervertebral disc or peripheral compression in the sciatic nerve. Occasionally the cause could be of a more serious nature like a nerve sheath tumor or more infrequently, lymphomatosis. We describe recurrent lymphoma in a patient who had been in remission presented with sciatica as result of the involvement of the nerve with metastatic tumor.

Recurrence of diffuse large B-cell lymphoma in sciatic and tibial nerves: A case report

“…Lymphoma is defined as a neoplastic proliferation of lymphoid cells from a secondary lymphoid structure, a lymph node or an extranodal structure. It is well established that extranodal site involvement is present in up to 40% of DLBCLs, and virtually any extranodal location can be a primary site [2] . However, peripheral nerve involvement in lymphomas is a rare manifestation, whether as an initial or recurrent presentation.…”

“…It could be also the first manifestation of non-Hodgkin`s lymphoma in rare cases, which is called primary neurolymphomatosis. Peripheral nerve involvement may manifest as solitary or multifocal lesions and sciatic nerve is the most common site for lymphoma involvement [2] . In addition, cranial nerves or spinal roots may be involved by lymphatic infiltration [ 3 , 4 ].…”

High-Grade B-Cell Lymphoma of the Sciatic Nerve That Mimicked a Schwannoma

“…Conversely, schwannomas are the most common peripheral nerve tumor, with an incidence of 0.3 to 0.4 cases per 100,000, and comprise 5% to 8% of all soft-tissue tumors 1 . Peripheral nerve lymphomas have been described as a dissemination of systemic disease or an extension of central nervous system involvement, but primary high-grade large B-cell lymphomas of the peripheral nervous system can occur and most frequently present in the sciatic nerve [2][3][4] .…”

“…Because of the difficulty in the diagnosis of neurolymphomatosis, radiculopathy in the setting of positive history of lymphoma should raise clinical concern. Deivaraju et al reported a case of recurrent diffuse large B-cell lymphoma of the sciatic nerve first identified on a routine surveillance PET-CT 4 . Their patient began to develop symptoms of radiculopathy concurrent with the timing of surveillance imaging.…”

“…Neurofibromas and schwannomas comprise nearly 100% of all benign sciatic nerve tumors 1 . However, high-grade B-cell lymphoma of the sciatic nerve can demonstrate a similar clinical and radiographic profile to these benign masses [2][3][4] . The symptomology of these masses often includes painful neuropathy or radiculopathy 5 .…”